EACS2023: 468 Estimated risk of all-cause mortality and cardiovascular events in a cohort of women living with HIV and socio-demographically similar HIV-negative controls ≥40 years old T. Povshedna , S.L. Levy , A.R Campbell , M. Lee , M.A. Prates Da Silva , C.V Mudhikwa , S.A Swann , E.M King , V. Nicholson , A. Kaida , M.C. Murray , H.C. Côté , for the British Columbia CARMA-CHIWOS Collaboration (BCC3, CTN 335) Team University of British Columbia, Pathology and Laboratory Medicine, Vancouver, Canada, University of British Columbia, Edwin S.H. Leong Centre for Healthy Aging, Vancouver, Canada, University of British Columbia, Centre for Blood Research, Vancouver, Canada, Women's Health Research Institute, Vancouver, Canada, British Columbia Women's Hospital and Health Centre, Oak Tree Clinic, Vancouver, Canada, Simon Fraser University, Faculty of Health Sciences, Burnaby, Canada, University of British Columbia, Department of Medicine, Faculty of Medicine, Vancouver, Canada, University of British Columbia, Experimental Medicine, Vancouver, Canada, BC Centre for Excellence in HIV/AIDS, Epidemiology and Population Health, Vancouver, Canada General data Abstract category: Ageing and frailty Abstract body Purpose: Understanding aging with HIV is crucial in light of increased life expectancy for people living with HIV globally. In Canada, this is especially true for women living with HIV (WLWH), who are at higher risk of mortality and concurrent health conditions compared to men living with HIV and are disproportionately affected by socio-structural adversities. We aimed to investigate estimated 5-year all-cause mortality and 10-year cardiovascular event risks in a cohort of WLWH and HIV-negative controls. Method: The British Columbia CARMA-CHIWOS Collaboration (BCC3) study is a prospective community-based cohort study of WLWH and HIV-negative women ≥16 years in British Columbia, Canada. Women ≥40 years without history of cardiovascular events were included in this analysis. The Veterans Aging Cohort Study (VACS) 2.0 Index and the Atherosclerotic Cardiovascular Disease (ASCVD) Risk Calculator were used to estimate risks of 5-year all-cause mortality and 10-year cardiovascular event, respectively. The groups were compared by Mann-Whitney, t-, or Chi-Squared tests. Results: WLWH (n=88) and controls (n=124) shared similar demographic characteristics (Table 1), apart from HCV which has the least impact on VACS 2.0 among all variables considered. Both risks increased with age (Figure 1A), and WLWH had higher VACS 2.0 compared to controls: median [IQR](range) 6.8 [3.9-18.7] (1.2-82.6)% vs 5.0 [3.3-6.8] (1.5-28.6)%, p<0.001, despite 93% having a viral load <200 copies/ml. HCV did not appear to be associated with VACS (Figure 1B). Further, there was no difference in proportions of WLWH or controls with intermediate-high (>7.5%) 10-year cardiovascular event risk: 16% vs 20% respectively, p=0.4. Table 1. Demographic characteristics of BCC3 study participants Parameter Women living with HIV (n=88) HIV-negative controls (n=124) P-value Age, median [IQR] (range), years 53 [47-59] (40-72) 55 [47-61] (40-78) 0.33 Ethnicity, n (%) White Indigenous Other racialized groups 41 (47) 26 (30) 21 (24) 55 (44) 37 (30) 32 (26) 0.93 HIV viral load (copies/ml), n (%) <40 40-200 >200 76 (86) 6 (7) 6 (7) N/A CD4 (cells/mm ), mean (SD) 623 (325) Not available High school graduate, n (%) 63 (72) 98 (79) 0.21 Ever experienced homelessness, n (%) 42 (48) 56 (46) 0.75 Current tobacco smoking, n (%) 35 (40) 44 (35) 0.52 Current illicit substance use*, n (%) 19 (22) 26 (21) 0.94 Hepatitis C virus (HCV) seropositive, n (%) 37 (42) 19 (15) <0.0001 Individual annual income <$20,000 CAD 44 (50) 53 (43) 0.30 * Self-reported frequency of use ≥ once per month (opioids, non-opioid sedating drugs, stimulants, psychedelics) HIV viral load 0 was conservatively used in the VACS 2.0 calculation for undetectable women living with HIV CD4=700 cells/mm was conservatively assumed for controls for the VACS 2.0 purposes Conclusions: Observed differences in estimated all-cause mortality, but not cardiovascular risk, suggest unique aging patterns in WLWH ≥40 years with mostly undetectable viral loads. Further investigation of factors affecting aging, including systemic inflammation, substance use, chronic pain, latent viral infections, and others, is warranted to identify actionable correlates of improved health outcomes in this population. General conditions 1. I confirm that I previewed this abstract and that all information is correct. I accept that the content of this abstract cannot be modified or corrected after the submission deadline and I am aware that it will be published exactly as submitted.: Yes 2. I confirm that the submission of the abstract constitutes my consent to publication (e.g. conference website, programmes, other promotions, etc.). : Yes 3. I herewith confirm that the contact details saved in this system are those of the corresponding author, who will be notified about the status of the abstract. The corresponding author is responsible for informing the other authors about the status of the abstract.: Yes 4. 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